Organization
GENESIS PHARMACY INC
Active
Other names
GENESIS DRUG INC
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HAGE RPH (OWNER)
(832) 925-8797
Entity
Organization
Contact information
Practice address
1611 SPENCER HWY STE F, SOUTH HOUSTON, TX 77587-3714
(832) 925-8797
(832) 925-8782
Mailing address
1611 SPENCER HWY STE F, SOUTH HOUSTON, TX 77587-3714
(832) 925-8797
(832) 925-8782
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
25156
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148758
—
TX
01
—
2099444
PK
—
Enumeration date
08/10/2006
Last updated
11/08/2018
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